How Bad Is Running For Your Knees?

I’m an avid runner, while my wife is a dedicated swimmer. Like many other runners, I consistently hear "running will kill your knees", most frequently from my wife. My normal response is to patiently explain why running is not bad for your joints.

Much to my surprise (after some years) my wife actually changed her response. Her new response is, "running may not kill your knees, but over time other exercises like swimming or biking are better for them." Do I need to surrender to my wife's superior argument or are there any studies that show comparative knee/joint health across a range of aerobic exercises?

The old school of thought on running was that it is bad for your knees. There are studies showing that runners are not at greater risk and some suggesting that runners have less risk of degenerative knee problems. I do not know of studies comparing the incidence or rate of degenerative knee problems in runners compared to other sports like swimming.

The key risk factors from my perspective are family history and previous knee trauma, especially ACL tears with or without repairs. ACL tears damage the articular cartilage and victims of this injury are getting knees replaced 15-20 years earlier than their non-injured peers. So this speaks to ACL injury prevention training. A good model for youth athletes and probably all of us is the 11+ exercise set promoted by FIFA. (To download a PDF that shows the exercises, click here.)

It is not possible to trade in your family history; if your parents or siblings have osteoarthritis in the knees or hips without a history of knee trauma, you may be wise to shift away from running at the first hint of knee or hip pain to a less impact-loading activity. Biking, swimming, and in-line skating come to mind.

Once you have OA, you should use pain as your guide. No pain = pursue your planned activity. Pain = move to gliding or non-impact activities. If you have a healthy joint, the cartilage may benefit from the compression and relaxation of the cartilage as a mechanism for driving nutrients into the cartilage matrix. The bottom line: If you are running, enjoying it, and not having pain – keep it up. If running is painful or not enjoyable, look for another activity.

Cheers, Bill

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